Patients on an Intermediate Medical Care
You have been assigned 4 patients on an Intermediate Medical Care Unit. Two of the patients are post myocardial infarctions at various stages of their infarctions with multiple types of arrhythmias, the third patient is having drastic blood sugar fluctuations 218 down to 50 within minutes and its rebounds back up with changes in mentation and the fourth is reported to be having frequent TIA's. One of the MI patients is having some dizziness and your TIA patient is presenting signs of impending stroke.
How would you prioritize your assessments and activities? How would you describe your critical thinking process and how do you organize and prioritize implementation of care?
Sample Solution
- Patient 1: This patient is a post-myocardial infarction (MI) patient with multiple types of arrhythmias. The most important assessment for this patient is to monitor their cardiac status. I would check their vital signs frequently, including their heart rate, blood pressure, and oxygen saturation. I would also monitor their ECG for any changes in their rhythm. If the patient experiences any chest pain, I would immediately notify the physician.
- Patient 2: This patient is also a post-MI patient, but they are at a later stage in their recovery. The most important assessment for this patient is to monitor their blood sugar levels. I would check their blood sugar levels every hour, and I would notify the physician if their levels are too high or too low. I would also monitor their mentation for any changes.
- Patient 3: This patient is experiencing drastic blood sugar fluctuations. The most important assessment for this patient is to monitor their blood sugar levels and their mentation. I would check their blood sugar levels every hour, and I would notify the physician if their levels are too high or too low. I would also monitor their mentation for any changes.
- Patient 4: This patient is experiencing frequent transient ischemic attacks (TIAs). The most important assessment for this patient is to monitor their neurological status. I would check their level of consciousness, their pupils, and their motor function. I would also monitor their vital signs for any changes.
- Identify the most important problems. The first step is to identify the most important problems for each patient. This can be done by considering the patient's medical history, their current condition, and their risk factors.
- Prioritize the assessments and activities. Once I have identified the most important problems, I can prioritize the assessments and activities that need to be done. This can be done by considering the urgency of the problem, the severity of the problem, and the patient's overall condition.
- Organize the implementation of care. Once I have prioritized the assessments and activities, I can organize the implementation of care. This includes making sure that the assessments and activities are done in a timely manner and that the results of the assessments are communicated to the physician.
- The patient's medical history
- The patient's current condition
- The patient's risk factors
- The most important problems
- The prioritized assessments and activities
- The timeline for completing the assessments and activities
- The communication plan